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Mohammed AM, Musa A, Etapelong SG, Bolori MT, Salanga DR, Ndahi D, Meleh S, Kunle I, Shettima A, Mohammed K, Siyaka SM, Manu IJ, Ilesanmi O, Adamu US, Shuaib F, Tesfaye E, Braka F, Mulombo WK. Expanding polio surveillance reach beyond vaccination reach in Borno State, Nigeria: The contribution of community informants from insecure areas engaged to conduct polio surveillance in security compromised areas, 2018-2019. Vaccine 2024; 42:770-776. [PMID: 37230888 DOI: 10.1016/j.vaccine.2023.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Borno state in north-eastern Nigeria is the epicentre of the >10 years' insurgency activities that have affected the region since 2009, resulting in the destruction of health facilities, killing of health workers, massive population displacement and lack of access to populations to provide health services. This article demonstrates how the involvement of community informants from insecure areas (CIIA) to conduct polio surveillance in security-challenged settlements of Borno state contributed to the expansion of polio surveillance reach beyond polio vaccination reach. METHOD In each of the 19 security compromised Local Government areas (LGAs) with community informants from insecure areas, Android phones enabled with Vaccination Tracking System (VTS) technology and Open Data Kit (ODK) mobile application were provided to capture geo-coordinates as evidence (geo evidence) for polio surveillance activity conducted. These geo evidence captured were uploaded and mapped to show insecure settlements reached with polio surveillance and those yet to be reached. RESULTS A total of 3183 security compromised settlements were reached for polio surveillance between March 2018 and October 2019 with valid geo evidence, 542 of these security-compromised settlements had not been previously reached by any other intervention for polio surveillance or polio vaccination. CONCLUSION The capturing of geo-coordinates as a proxy indicator of polio surveillance activity conducted by informants provided significant evidence of settlements reached for sustained polio surveillance even when a case of Acute Flaccid Paralysis (AFP) had not been reported from these settlements. Using the geo evidence captured by CIIA in insecure settlements, we have demonstrated the expansion of polio surveillance reach beyond polio vaccination reach in Borno state.
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Affiliation(s)
| | - Audu Musa
- World Health Organization, Borno State Office, Maiduguri, Nigeria
| | | | | | | | - Danladi Ndahi
- World Health Organization, Borno State Office, Maiduguri, Nigeria
| | - Sule Meleh
- State Primary Health Care Development Agency (SPHCDA), Nigeria
| | - Ijaya Kunle
- World Health Organization, Borno State Office, Maiduguri, Nigeria
| | - Aliyu Shettima
- State Primary Health Care Development Agency (SPHCDA), Nigeria
| | - Kabiru Mohammed
- National Primary Health Care Development Agency (NPHCDA), Nigeria
| | | | - Idris Jibrin Manu
- African Field Epidemiology Network, Nigeria Stop Transmission of Polio Program, Abuja, Nigeria
| | | | - Usman S Adamu
- National Primary Health Care Development Agency (NPHCDA), Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency (NPHCDA), Nigeria
| | - Erbeto Tesfaye
- World Health Organization, Country Office, Abuja, Nigeria
| | - Fiona Braka
- World Health Organization, Country Office, Abuja, Nigeria
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Wakam Nkontchou B, Guenou E, Buh Nkum C, Mairousgou Tchida C, Nono AM, Ateudjieu J. The Polio Vaccination Status of Non-polio Acute Flaccid Paralysis Cases in the Far North Region of Cameroon: A Five-Year Retrospective Study From 2015 to 2019. Cureus 2024; 16:e52740. [PMID: 38384598 PMCID: PMC10880869 DOI: 10.7759/cureus.52740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND The Expanded Program on Immunization (EPI) of Cameroon contributes to the reduction of polio, but the rate of non-polio acute flaccid paralysis (NPAFP) is still high. The aim of this study was to describe the immunization profile of NPAFP cases and the performance of polio surveillance in the Far North Region of Cameroon between 2015 and 2019. METHODS A retrospective secondary data analysis was conducted using the national EPI and regional AFP surveillance case-based database from 2015 to 2019. Analyses were carried out using Epi-Info statistical software (version 7) (Centers for Disease Control and Prevention, Atlanta, GA). RESULTS The surveillance network of the region reported 848 cases of NPAFP between 2015 and 2019. The sex distribution of the AFP cases revealed that 43.3% were females and 56.7% were males. Cases with AFP aged less than five years accounted for the largest proportion of cases (67.2%). Overall, 733/848 (86.4%) of the AFP cases received at least three doses of the oral polio vaccine (OPV). The AFP detection rate substantially increased in the region after the introduction of community-based surveillance in 2016. The mean NPAFP level during the study period was 7.3/100,000 children aged less than 15 years. The mean proportion of AFP cases with two adequate stools was 668/848 (78.7%), and the mean proportion of stools to the national reference laboratory within three days was 466/848 (54.9%). CONCLUSION Only 86.4% of AFP cases received three or more doses of OPV required for immunization. The stool specimen management indices were not good enough to confirm that no case of poliovirus was missed in the laboratory. To strengthen the country's polio-free status, surveillance should be strengthened in least-performing health districts to improve the quality of AFP case investigations after detection.
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Affiliation(s)
| | - Etienne Guenou
- Epidemiological Surveillance Section, National Public Health Laboratory, Ministry of Public Health, Yaoundé, CMR
- Health Research, Meilleur Accès aux Soins de Santé (M.A. SANTE), Yaoundé, CMR
| | - Collins Buh Nkum
- Health Research, Meilleur Accès aux Soins de Santé (M.A. SANTE), Yaoundé, CMR
- Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, CMR
| | - Celine Mairousgou Tchida
- Regional Centre for Epidemic Prevention and Control, Far North Regional Public Health Delegation, Ministry of Public Health, Maroua, CMR
| | | | - Jerome Ateudjieu
- Health Research, Meilleur Accès aux Soins de Santé (M.A. SANTE), Yaoundé, CMR
- Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, CMR
- Division of Health Operations Research, Cameroon Ministry of Public Health, Yaoundé, CMR
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3
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Hamisu AW, Etapelong SG, Ayodeji I, Richard B, Fiona B, Gidado S, Abbott SL, Edukugho AA, Bolu O, Adeyelu A, Mawashi KY, Adamu US, Nsubuga P, Shuaib F. Experience and findings from surveillance peer review in Nigeria, August 2017-May 2019. Pan Afr Med J 2023; 45:9. [PMID: 38370096 PMCID: PMC10874099 DOI: 10.11604/pamj.supp.2023.45.2.39450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 08/23/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction acute flaccid paralysis (AFP) surveillance is the gold standard of the Global Polio Eradication Initiative (GPEI) for detecting cases of poliomyelitis and tracking poliovirus transmission. Nigeria's AFP surveillance performance indicators are among the highest in countries of the World Health Organization (WHO) African Region. The primary AFP surveillance performance indicators are the rate of non-polio AFP among children and the proportion of timely, adequate specimen collection. The surveillance working group of the National Emergency Operations Centre assessed the quality of AFP surveillance data in some reportedly high-performing states. Methods we conducted a retrospective review of AFP surveillance performance indicators in Nigeria for 2010-2019. We also reviewed data in reports from four groups of surveillance peer reviews and validation visits (conducted by in-country GPEI partners) during August 2017-May 2019 in 16 states with high primary AFP surveillance indicators; the validation visits reviewed clinical information and the dates of specimen collection and onset of paralysis with caretakers. Results there were consistently increasing AFP surveillance primary performance indicators during 2010-2016, followed by declines during 2017-2019. From the data for 16 states with peer reviews conducted from August 2017-May 2019, overall concordance of reported and "true" (validated) AFP indicator data in peer review investigations was highly variable. True AFP concordance ranged from 58%-100%, and stool timeliness concordance ranged from 56%-95%. The most common clinical causes of reported AFP cases that were not true AFP were spastic paralysis, malaria, sickle cell disease, and malnutrition. All the states that participated in peer reviews developed surveillance improvement plans based on the gaps identified. Conclusion Nigeria has highly sensitive AFP surveillance according to reported primary AFP performance indicators. The findings of peer reviews indicate that the AFP surveillance system needs to be strengthened and well-supervised to enhance data quality.
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Affiliation(s)
| | | | - Isiaka Ayodeji
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Banda Richard
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Braka Fiona
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Saheed Gidado
- National Stop Transmission of Polio (NSTOP)/African Field Epidemiology Network (AFENET), Aso, Federal Capital Territory, Abuja, Nigeria
| | - Samuel Luka Abbott
- National Stop Transmission of Polio (NSTOP)/African Field Epidemiology Network (AFENET), Aso, Federal Capital Territory, Abuja, Nigeria
| | - Aboyowa Arayuwa Edukugho
- National Stop Transmission of Polio (NSTOP)/African Field Epidemiology Network (AFENET), Aso, Federal Capital Territory, Abuja, Nigeria
| | - Omotayo Bolu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Asekun Adeyelu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | | | - Usman Said Adamu
- National Primary Healthcare Development Authority, Abuja, Nigeria
| | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, United States
| | - Faisal Shuaib
- National Primary Healthcare Development Authority, Abuja, Nigeria
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4
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Bammeke P, Adamu US, Bolu O, Waziri N, Erberto T, Aregay A, Nsubuga P, Wiesen E, Shuaib F. Descriptive epidemiology of poliomyelitis cases due to wild poliovirus type 1 and wild poliovirus type 3 in Nigeria, 2000-2020. Pan Afr Med J 2023; 45:4. [PMID: 38370099 PMCID: PMC10874097 DOI: 10.11604/pamj.supp.2023.45.2.38079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/18/2022] [Indexed: 02/20/2024] Open
Abstract
Introduction in August 2020, the World Health Organization African Region was certified free of wild poliovirus (WPV) when Nigeria became the last African country to interrupt wild poliovirus transmission. The National Polio Emergency Operations Center instituted in 2012 to coordinate and manage Nigerian polio eradication efforts reviewed the epidemiology of WPV cases during 2000-2020 to document lessons learned. Methods we analyzed reported WPV cases by serotype based on age, oral poliovirus vaccine immunization history, month and year of reported cases, and annual geographic distribution based on incidence rates at the Local Government Area level. The observed trends of cases were related to major events and the poliovirus vaccines used during mass vaccination campaigns within the analysis period. Results a total of 3,579 WPV type 1 and 1,548 WPV type 3 laboratory-confirmed cases were reported with onset during 2000-2020. The highest WPV incidence rates per 100,000 population in Local Government Areas were 19.4, 12.0, and 11.3, all in 2006. Wild poliovirus cases were reported each year during 2000-2014; the endemic transmission went undetected throughout 2015 until the last cases in 2016. Ten events/milestones were highlighted, including insurgency in the northeast which led to a setback in 2016 with four cases from children previously trapped in security-compromised areas. Conclusion Nigeria interrupted WPV transmission despite the challenges faced because of the emergency management approach, implementation of mass vaccination campaigns, the commitment of the government agencies, support from global polio partners, and special strategies deployed to conduct vaccination and surveillance in the security-compromised areas.
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Affiliation(s)
- Philip Bammeke
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | | | - Omotayo Bolu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | | | | | | | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, United States
| | - Eric Wiesen
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Faisal Shuaib
- National Primary Healthcare Development Agency, Abuja, Nigeria
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5
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Ioannidou C, Galanis P, Voulgari-Kokota A, Dikalioti SK, Papachristidou S, Bozas E, Mentis A, Tsoumakas K, Pavlopoulou ID. Suboptimal Serologic Immunity Against Poliomyelitis Among New Migrant Children in Greece Calls for Organized Action. J Immigr Minor Health 2023; 25:96-103. [PMID: 35441972 DOI: 10.1007/s10903-022-01363-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 01/10/2022] [Accepted: 03/24/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Migration-flows pose the risk of poliovirus reintroduction from endemic countries to Greece. This study aims to evaluate serologic-immunity/vaccination against poliomyelitis in newly-arriving migrant children. METHODS Demographic-immunisation data and blood-serum were obtained from migrants 1-14years-old, referred to a hospital-clinic in Athens-Greece within three months from arrival. Immunity to polioviruses-1-3 was determined by serum-neutralizing-antibodies(WHO guidelines). Titers ≥ 1:8 were considered positive. RESULTS From 9/2010 to 9/2013, 274 children(150 refugees/124 immigrants), mean age 7.1years-old, were enrolled. Only 57(20.8%) of them presented with vaccination-records. Children originated mainly from Asia(n = 198), Eastern Europe(n = 28), Middle East(n = 24) and Africa(n = 24) with 160(58.4%) from polio-endemic-countries(Afghanistan-112(40.8%), Pakistan-24(8.8%) and India-24(8.8%)). Seropositivity against polio-1-2&3 was 84.3%, 86.1% and 74.5%, respectively. Immigrants, had higher seroprotective rates against polioviruses-1-2&3 than refugees(polio-1:p = 0.002;polio-2:p = 0.004,polio-3:p < 0.001). Seronegativity to 1PVs-2PVs and all three polio serotypes was found in 37(13.5%),12 (4.4%), and 30 children(10.9%) respectively. Increasing number of vaccine-doses, and younger-age, were positively-associated with seropositivity. DISCUSSION A remarkable fraction of newly-arrived migrant-children were seronegative to one or more polioviruses.
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Affiliation(s)
- Christina Ioannidou
- Pediatric Research Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Papadiamantopoulou 123, P.O. 11527, Goudi, Athens, Greece
| | - Petros Galanis
- Department of Public Health Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, Papadiamantopoulou 123, 11527, Goudi, Athens, Greece
| | - Androniki Voulgari-Kokota
- The National Polio- Enteroviruses Laboratory, Hellenic Pasteur Institute, 127 Vasilissis Sophias Ave, 11521, Athens, Greece
| | - Stavroula K Dikalioti
- Pediatric Research Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Papadiamantopoulou 123, P.O. 11527, Goudi, Athens, Greece. .,Faculty of Nursing, Pediatric Clinic, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian National and Kapodistrian University of Athens, Thivon & Levadeias str, 11527, Athens, Greece.
| | - Smaragda Papachristidou
- Faculty of Nursing, Pediatric Clinic, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian National and Kapodistrian University of Athens, Thivon & Levadeias str, 11527, Athens, Greece
| | - Evangelos Bozas
- Pediatric Research Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Papadiamantopoulou 123, P.O. 11527, Goudi, Athens, Greece
| | - Andreas Mentis
- The National Polio- Enteroviruses Laboratory, Hellenic Pasteur Institute, 127 Vasilissis Sophias Ave, 11521, Athens, Greece
| | - Konstantinos Tsoumakas
- Faculty of Nursing, Pediatric Clinic, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian National and Kapodistrian University of Athens, Thivon & Levadeias str, 11527, Athens, Greece
| | - Ioanna D Pavlopoulou
- Pediatric Research Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Papadiamantopoulou 123, P.O. 11527, Goudi, Athens, Greece.,Faculty of Nursing, Pediatric Clinic, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian National and Kapodistrian University of Athens, Thivon & Levadeias str, 11527, Athens, Greece
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6
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Ahmed SH, Nguku P, Gidado SO, Bawa MK, Shehu UL, Abdullahi A, Obansa RU, Getso KI, Mahmoud MN, Bello IW, Sharif YM, Abba B, Umar S, Waziri NE, Ohunabunwo C. Progress toward poliomyelitis eradication in Kano State, Nigeria, 2010 - 2017. Pan Afr Med J 2021; 40:9. [PMID: 36157557 PMCID: PMC9474848 DOI: 10.11604/pamj.supp.2021.40.1.19318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 02/13/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction Kano State in Northern Nigeria was a major source of Wild Polio Virus (WPV) cases in Nigeria up until 2015. In 2009, the State reported 168 WPV cases out of the 388 reported nationally. This paper characterizes the progress made by Kano State in polio eradication. Methods In December 2017, we conducted a descriptive review of Routine Immunization (RI) from both the District Vaccine Data Management Tool (DVD-MT) and District Health Information System (DHIS2) from 2010 to 2017. Also, we reviewed the Acute Flaccid Paralysis (AFP) and Supplementary Immunization Activities (SIAs) data reported for Kano State from 2010 to 2017. Also, we obtained the number of reported WPV cases by serotypes. Results From 2010 to 2017, a total of 65 confirmed WPV cases were reported in Kano State. Of these, 58 (89%) were WPV1 and 7 (11%) WPV3. Almost half of these cases were reported in 2012 from 14 LGAs. The number of reported cases fell to 15 (23%) in 10 LGAs in 2013, and further decreased to 5 (8%) in four LGAs in 2014. No new WPV cases have been detected in Kano since 2015. During the same period, 23 circulating Vaccine Derived Polio Viruses (cVDPV2) cases were reported in Kano. Specifically, 10 LGAs reported 10 cases in 2011. Three LGAs reported three cases in 2012, while eight LGAs reported 10 total cases in 2014. During the 2010 to 2017 period 61 SIAs were conducted. Conclusion Kano State made progress toward polio eradication. Sustained eradication efforts, in form of high quality RI, SIAs and AFP surveillance are necessary to avert possible importation from 2016 polio resurgence in nearby Borno State, Nigeria.
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Affiliation(s)
- Suleiman Haladu Ahmed
- Field Epidemiology Network, Abuja, Nigeria,,Corresponding author: Suleiman Haladu Ahmed, African Field Epidemiology Network, Abuja, Nigeria.
| | | | | | | | | | | | | | | | | | | | | | - Bashir Abba
- World Health Organization, Kano Office, Nigeria
| | - Sani Umar
- World Health Organization, Kano Office, Nigeria
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Raji IA, Abubakar AU, Ahmad A, Gidado S, Olorukooba AA, Lawal BB, Umeokonkwo CD, Balogun M. Evaluation of acute flaccid paralysis surveillance indicators in Sokoto state, Nigeria, 2012-2019: a secondary data analysis. BMC Public Health 2021; 21:1148. [PMID: 34130684 PMCID: PMC8207697 DOI: 10.1186/s12889-021-11238-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 06/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background Nigeria, the last endemic country in the WHO African Region, was certified free of Wild Polio Virus (WPV) in 2020. However, due to low immunity in some communities in Sokoto, outbreaks of the circulating Vaccine Derived Polio Virus (cVDPV) occur. The aim of this study is to evaluate the Acute Flaccid Paralysis (AFP) surveillance indicators in Sokoto state, Nigeria. Methods This retrospective study was an analysis of routinely collected AFP surveillance data between 2012 and 2019 by the Sokoto state surveillance network. We assessed the Sokoto state AFP surveillance system using the AFP surveillance performance indicators. We performed all analyses using Microsoft Excel 2019. Results Cumulatively, 3001 Acute Flaccid Paralysis (AFP) cases were reported over the evaluation period, out of which 1692 (56.4%) were males, and 2478 (82.4%) were below five years. More than half, 1773 (59.1%), had a fever at the beginning of the disease, and 1911 (63.7%) had asymmetric paralysis. The non-polio AFP rate (9.1 to 23.5% per 100,000 children < 15 years old) and stool adequacy rate (92.5 to 100%) indicate high sensitivity. The proportion of cases that had stool samples collected early, timely transported to the laboratory and arrived at the laboratory in optimal condition were all above the World Health Organization (WHO) minimum standard of 80%. There was inadequate profile documentation of some suspected cases. Conclusions Sokoto State has exceeded the WHO minimum standards in most of the AFP surveillance indicators. The performance of the system is sufficient enough to detect any reintroduction of WPV into the state. However, there is a need for improvement in data quality.
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Affiliation(s)
- Ismail Abdullateef Raji
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria. .,Department of Community Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
| | - Auwal Usman Abubakar
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria.,Department of Community Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | | | | | | | - Bola Biliaminu Lawal
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria.,Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Chukwuma David Umeokonkwo
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria.,Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi, Nigeria
| | - Muhammad Balogun
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
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8
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Adamu US, Archer WR, Braka F, Damisa E, Siddique A, Baig S, Higgins J, Sume GE, Banda R, Korir CK, Waziri N, Gidado S, Bammeke P, Edukugo A, Nganda GW, Forbi JC, Burns CC, Liu H, Jorba J, Asekun A, Franka R, Wassilak SG, Bolu O. Progress Toward Poliomyelitis Eradication - Nigeria, January 2018-May 2019. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2019; 68:642-646. [PMID: 31344023 PMCID: PMC6660103 DOI: 10.15585/mmwr.mm6829a3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The number of wild poliovirus (WPV) cases in Nigeria decreased from 1,122 in 2006 to six WPV type 1 (WPV1) in 2014 (1). During August 2014-July 2016, no WPV cases were detected; during August-September 2016, four cases were reported in Borno State. An insurgency in northeastern Nigeria had resulted in 468,800 children aged <5 years deprived of health services in Borno by 2016. Military activities in mid-2016 freed isolated families to travel to camps, where the four WPV1 cases were detected. Oral poliovirus vaccine (OPV) campaigns were intensified during August 2016-December 2017; since October 2016, no WPV has been detected (2). Vaccination activities in insurgent-held areas are conducted by security forces; however, 60,000 unvaccinated children remain in unreached settlements. Since 2018, circulating vaccine-derived poliovirus type 2 (cVDPV2) has emerged and spread from Nigeria to Niger and Cameroon; outbreak responses to date have not interrupted transmission. This report describes progress in Nigeria polio eradication activities during January 2018-May 2019 and updates the previous report (2). Interruption of cVDPV2 transmission in Nigeria will need increased efforts to improve campaign quality and include insurgent-held areas. Progress in surveillance and immunization activities will continue to be reviewed, potentially allowing certification of interruption of WPV transmission in Africa in 2020.
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